Integrated Treatment 整合性治療

Body motion is a serial change of different joints, so the treatment of a joint not only changes the one joint but also other several joints. This connection between different joints is called “Joint Puzzle” or “Joint Chain.” And all of the motions of joints are controlled by brain through nerves. If a treatment can not change the brain setting, CNS setting, or give a new stimulation or sensory input, the body will go down to the same old pathway and the change will be limited. Therefore, an effective treatment has to consider the connection between different joints and the stimulation given to CNS.

身體動作乃是一連串不同關節的動作組合而成，故當我們對單一關節進行治療時會連帶影響其他關節，這種不同關節間的連結被稱之為關節拼圖或關節鏈，而所有關節的動作乃是由腦部透過神經來控制，因此，若是治療無法藉由給予新的感覺刺激來改變原先腦部的設定，使腦部送出來的動作輸出不同，身體仍會依循舊有的習慣而難以有所變化，因此，一個有效的治療必須考慮各不同關節間的連結和所給予中樞神經的新刺激。

In breathing system, body will generate specific posture subconsciously according to a more inhalation or exhalation condition unless we consciously control our breath. For this system, we focus on maintaining and restoring the functions of muscles and joint to let body can accommodate itself to the effect of breathing.

在呼吸系統部分，人體為了因應較呼氣或較吸氣的情況，身體會下意識地產生特定的姿勢，這是身體非意識下的自然反應，因為呼吸本身是非意識的動作，除非刻意。針對此系統我們著重在維持與恢復肌肉及關節的功能，使身體能正常地適應在呼吸時所產生的影響。

When the body is overloading or overuse, the pressure may cause muscle tightness or spasm, and prolonged muscle tightness or spasm may result in muscle loosening or fatigue. Muscle spasm and tightness is the reflex involuntary contraction of muscles for fighting against or absorbing pressure because the muscles could not provide sufficient strength and endurance and become weakness. As time goes on, the muscle no longer contracts subconsciously and will fatigue eventually. When the muscle fiber loses its function, it will further induce more pain or other physiological symptoms. This condition can be observed more in slow twitch muscle fiber than in fast twitch muscle fiber. In regard to this problem, using active contraction during persistent passive stretch can help the spasm or fatigue muscle regain its normal function by reeducating the slow twitch muscle fiber. But, treating one muscle at one time is time consuming and it might take a long time to get a significant change. Therefore, joint training which consists multiple muscles at one time is introduced to accelerate the process of recovery. However, some muscles are hard to be classified into any specific joint, such as diaphragm or intercostal muscles, and can only be treated separately. So, it is still necessary to use active contraction during persistent passive stretch to treat these muscles.

當身體負荷過重或過度使用時，壓力可能會造成肌肉緊張或肌肉痙孿，而長期的肌肉緊張或痙孿則可能導致肌肉無力或肌肉疲勞。肌肉緊張和痙孿皆是由於肌肉無法提供足夠的肌力和肌耐力而漸漸造成無力，以置於身體必須透過肌肉的反射性非自主收縮來抵抗或承受壓力，但隨著肌肉緊張和痙孿的時間拉長，肌肉開始疲勞，最終將不再收縮而呈現無力的鬆弛狀態，而這狀態常常會導至疼痛或其他生理性症狀，並且這樣的情況也較常見於慢縮肌纖維；因此，對於這類情形，可以透過在持續被動延展下的主動收縮訓練來重新教育慢縮肌纖維，使緊張的肌肉放鬆且使無力鬆弛的肌肉縮短。但是，一條條肌肉的治療耗時太長，要看見顯著的改變實為不易，所以可以同時訓練一組肌肉群的關節訓練便被引進，來加速治療的步驟，不過有些肌肉不特別屬於任何關節，例如橫隔肌或肋間肌等呼吸肌肉，只能單獨訓練，因此這種在持續被動延展下的主動收縮訓練仍有其存在的必要性。

In the treatment of joint, the most important key is anti-gravity and shearing GRF. Under the influence of gravity and GRF, joint is placed in a loading situation which may reduce the joint space and degenerate the joint. For example, knee joint has to bear the weight from upper body and shear the GRF from foot at the same time. It does not mean there is nothing good of loading because body do need loading to acquire joint sensation and keep the density of bone. But in order to let gravity and GRF to do their works, we must realign the joint and give the joint space back by unloading the joint first. And then, the joint can be trained under a better condition.

在關節訓練上，抗重力和分散地心引力之反作用力的觀念是治療的關鍵，因為對一個關節來說不論是由上而下的重力，或下而上的反作用力，都是使關節空間變狹窄並加速退化的因素，比如說膝關節，有從下而上的反作力及上而下的身體重量，然而並不是說重力及反作用力對人體只有壞處沒好處，畢竟人體透過這些力可以維持骨質密度及接受感覺回饋來使身體平衡，但是在使這些力發揮良好功用前，必須使各關節處在適當的排列上，並且藉由關節減壓讓各關節都保有足夠的空間來活動和接受訓練。

Compared to breathing system, eye and head systems focus mainly on conscious nerve control. In our daily life, we usually first have sensory input from eyes to the brain and then have motor output. And the sensory input of eyes has great impact on body posture and balance. So, when we cover the dominant eye or non-dominant eye to modify the sensory input, the brain or central nervous system will adjust the nerve circuit and conduction to rearrange or adjust the motor output and cause the changing of body motion posture consequently. On the other hand, the head position in the space can also affect body posture. That’s the control of body balance from the vestibular system. If we can change the position of head, such as anterior or posterior tilt, or left or right tilt, the sensory input and motor output will be changed as well. Besides, eye and head systems control mostly the fast twitch muscle fiber, so the training includes muscle strengthening and agility training. Muscle strengthening can improve muscle function. Agility training can enhance the muscle control and muscle recruitment to help the joint move more smoothly.

在眼睛系統及頭部系統較部分，著重在意識下的神經控制。生活中有許多動作是透過我們的眼睛觀察，然後大腦發出訊息來控制身體及手腳來完成，而且眼睛輸入的視覺訊息對於身體的姿勢及平衡亦有極大的影響，故當我們藉由遮住慣用眼或非慣用眼的方式來改變感覺輸入時，腦便會調整其神經迴路及傳導來修正動作的輸出指令，來達到動作及姿勢的改變。另外，頭部的空間位置也會對身體有很大的影響，也就是前庭系統在身體平衡上的控制，如果我們能改變頭部前、後傾，或左、右傾的位置，那麼神經訊息的輸入及輸出亦會受到調整。再者，此系統對動作及動態姿勢的調控，多由快縮肌纖維來支配，因此，眼睛及頭部二系統的訓練包含了加強肌肉力量來增進肌肉功能，以及透過反覆性和快速反應的訓練來增加神經對肌肉的控制及提高肌肉徵召比例，進而提高關節動作的流暢度。

In the integrated treatment, the Breathing, Eye-TMJ, and Head systems trainings are specially designed and specific for patients of different types of posture. However, these trainings can hardly adjust the joints of spine, so spine manipulation is a good choice of enhancing the treatment effect by helping the body to be trained under better position of spine. But it doesn’t mean the body can’t recover without spine manipulation. It just takes longer time to heal. On the other hand, spine manipulation seems to be recurrent easily if the muscles are not trained to coordinate, so we should get better result when using both treatments.

呼吸系統、眼-顳顎關節系統及頭部系統的訓練內容會針對不同姿勢類型的病人而設計，然而，這些訓練比較難改變脊椎的關節，所以，加上脊椎矯正剛好可以使身體動作的改變更完整，也就是說若脊椎可以在較正確或適當的排列下接受訓練，治療的效果應會較佳，脊椎兩側的肌肉或是更遠端的肌肉也能在正確的骨骼排列下被再教育，但並非不加上脊椎矯正就無法恢復，只是療程上可能會較長一些。而單純脊椎矯正常因肌肉沒有受過訓練，以至於肌肉缺乏彈性，而使被矯正好的脊椎較易跑回原本的位置，故兩者並用可以收到較佳的結果。